The Sage Group

In Recognition of National Diabetes Month, THE SAGE GROUP LLC Highlights the Interrelationships Between Peripheral Artery Disease (PAD) and Diabetes, Diabetic Foot Ulcers (DFU) and Amputation

ATLANTA, November 12, 2013 (BUSINESS WIRE)—According to THE SAGE GROUP research, approximately 50% of diabetic foot ulcer (DFU) patients also suffer from peripheral artery disease (PAD).

“The presence of PAD is important because DFU with PAD are different in terms of severity, location, infection, morbidity, mortality and costs,” declared Mary L. Yost, President. “Recognizing these differences, the European Study Group on Diabetes and the Lower Extremity (EURODIALE) authors concluded that DFU with and without PAD should be considered two separate diseases.”

“PAD is associated with adverse DFU outcomes including a lower probability of healing, longer healing times, greater probability of ulcer recurrence, greater risk of toe as well as major amputations and higher mortality,” continued Yost. “Furthermore, the risk of non-healing ulcers, amputation and mortality increase with PAD severity.

DFU are a frequent and costly complication of diabetes. Diabetics have a 15%-25% lifetime risk of developing a foot ulcer. DFU precede 85% of all amputations.

“The U.S. is experiencing an epidemic of diabetes with the fastest increases occurring in senior citizens. Currently, 36% of those 65 and older have diabetes, up from 19.5% in 1995,” observed Yost.

Commenting on the impact of diabetes on PAD Yost elaborated, “Diabetes is a significant risk factor for PAD increasing the risk by 1.5 to 4 times. Furthermore, PAD is much more virulent in diabetics. Diabetics tend to have more severe ischemia, a greater number of amputations, higher mortality and die at a younger age.”

“Critical limb ischemia (CLI), the most severe and deadly form of PAD, is closely linked with diabetes. Although only about 13% of U.S. population is diabetic, 60%-80% of CLI patients are diabetics. Most CLI cases occur in those 65 and older,” Ms. Yost observed.

Explaining how the presence of diabetes increases the severity of CLI Yost stated, “CLI develops suddenly in diabetics and they are more likely to present with tissue loss. Diabetes increases the risk of amputation and amputation risk increases with severity of diabetes. Older diabetics with CLI have higher rates of amputation than younger.”

“We estimate that 65,000-70,000 major amputations (above-the-knee and below-the-knee) are performed annually in the U.S. for CLI,” Yost stated. “Conservatively, these amputations cost $10.6 billion with Medicare and Medicaid paying almost 80% of the bill.”

Ms. Yost continued, “Tragically, amputation is frequently the first and the only therapy for CLI. Between one-quarter and one-third of CLI patients undergo primary amputation with no attempt at revascularization.”

THE SAGE GROUP, a research and consulting company, specializes in atherosclerotic disease in the lower limbs, specifically PAD, intermittent claudication (IC), CLI, Acute Limb Ischemia and ischemic diabetic foot ulcers. The most recent research focuses on quantifying the economic and social costs of PAD and CLI-related amputations.

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